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https://doi.org/10.14300/mnnc.2019.14043

Treatment of patients with combined haemorrhoids by minimally invasive methods in outpatient conditions

[Surgery]
Vasiliy Sotnikov; Sergey Katorkin; Pavel Andreev;

Among 103 patients, latex ligation of internal hаemorrhoids was performed. Patients (n=103) were divided into the main (n=51) and control (n=52) groups. In the main group, treatment was supplemented with postoperative treatment of the perianal area with Hepatrombin H® ointment and excision of external hаemorrhoids. In the course of treatment, blood flow velocity was measured in external hаemorrhoids using sonography before ligation 1 and 2 (1 and 10) 30 days after the end of treatment. In patients of both groups, on day 10 after the first latex ligation, there was a decrease in the maximum and minimum blood flow rates by 35.7±16.7 % and by 30.5±13.6 %, respectively. In 2 patients (4.1 %) in the control group, after the first ligation, exacerbation of external haemorrhoids developed. During a year after the treatment, 6 patients (11.6 %) in the control group were treated for exacerbations of haemorrhoids. After 1 year, in 9 patients (17.4 %) in the control group and in 4 patients (7.9 %) in the main group, prolapses of internal haemorrhoids were detected. Thus, with the addition of latex ligation with postoperative treatment of external haemorrhoids with Hepatrombin H® ointment and their subsequent excision, a decrease in the number of postoperative exacerbations and improvement of long-term treatment results was observed.

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Keywords: combined haemorrhoids, ligation of internal haemorrhoids with latex rings, minimally invasive technologies, postoperative complications